The DOT physical and the medical examiner's certificate
Updated September 3, 2026 · 7 min read
Every driver operating a commercial motor vehicle must be medically certified as physically qualified under 49 CFR 391.41. The exam produces a medical examiner's certificate — the med card. It is the single most common expiring document in a small fleet, and the one most likely to lapse quietly, because it does not expire on a schedule anyone shares.
How long it lasts
The maximum is 24 months. That is a ceiling, not a default.
An examiner can and routinely does issue a certificate for less — 12 months, six months, sometimes three — when a condition needs monitoring. Blood pressure is the usual reason. A driver with hypertension under control may be certified for a year at a time indefinitely.
This is what makes med cards hard to track by hand. Two drivers examined on the same day can have certificates expiring two years apart, and nothing about the card announces which one you are holding except the date printed on it.
Who is allowed to perform it
Only a medical examiner listed on FMCSA's National Registry of Certified Medical Examiners. A physical from a doctor who is not on the registry does not qualify the driver, however thorough the exam was.
This catches carriers who send a driver to their regular physician or to whichever urgent care is closest. The examiner must be on the registry on the date of the exam — worth checking before the appointment rather than after.
What it costs
Typically somewhere between $75 and $150 depending on the clinic, and it is generally not billed to health insurance, because it is an employment requirement rather than medical care. Urgent care and occupational health chains are usually at the lower end.
If an examiner requires additional testing — a sleep study, a cardiac workup, a follow-up on blood pressure — that is billed separately and can dwarf the cost of the exam itself.
What the carrier has to keep
The medical examiner's certificate belongs in the driver qualification file, and it has to be current, not merely present. An expired card in a complete-looking DQ file is still a violation, and it is the kind an auditor finds in seconds by sorting on a date.
For CDL holders, examination results are now transmitted electronically from the examiner to FMCSA and on to the state licensing agency, rather than the driver walking a paper copy to the DMV. Confirm the current documentation requirement against FMCSA guidance before changing how you file these — this area has moved recently, and what your records should contain depends on which rule is in force when you are audited.
Whatever the filing mechanism, the operational requirement has not changed: a driver whose certification has lapsed is not qualified, and must not be dispatched.
Common questions
How long is a DOT physical good for?
Up to 24 months. Examiners frequently issue certificates for shorter periods — commonly 12 months, sometimes three or six — when a condition such as high blood pressure is being monitored. The certificate itself states the expiry date.
How much does a DOT physical cost?
Usually $75 to $150. It is normally not covered by health insurance because it is an employment requirement rather than treatment. Any follow-up testing the examiner orders is billed separately.
How often do you need a DOT physical?
At least every 24 months, and more often if your certificate was issued for a shorter period. The interval is set by the examiner based on your health, not by a fixed national schedule.
Who can perform a DOT physical?
Only a medical examiner listed on FMCSA's National Registry of Certified Medical Examiners. An exam by a physician not on the registry does not medically qualify the driver.
Do I need a medical examiner's certificate?
Yes, if you operate a commercial motor vehicle subject to 49 CFR Part 391. That includes owner-operators driving under their own authority — being the company owner does not exempt you from being medically qualified.
What happens if my medical card expires?
You are no longer medically qualified and must not operate a CMV until you are recertified. For the carrier it is a driver qualification violation, and dispatching an uncertified driver is the kind of finding that escalates an audit quickly.
Stop tracking this by hand
DOTCurrent watches every dated requirement across your fleet — medical cards, MVR reviews, Clearinghouse queries, annual inspections, MCS-150, UCR and your random testing pace — and emails you before anything expires. Flat $149/month, any fleet size up to 50 drivers.
Keep reading
This guide is general information, not legal advice. Regulations change; verify against the current text of 49 CFR and your state's rules before relying on any of it.